How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,570.40 Median $5,248.07 Typical High $10,964.78 | Facility | None | $2,570.40 | $5,248.07 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $120.23 | Professional | None | $104.71 | $112.20 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $371.54 | Facility | None | $89.13 | $169.82 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $223.87 | Professional | None | $100.00 | $117.49 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | None | $151.36 | $204.17 | $204.17 |
Horizon BCBS Setting Facility Modifier None Typical Low $141.25 Median $251.19 Typical High $933.25 | Facility | None | $141.25 | $251.19 | $933.25 |
Horizon BCBS Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $245.47 | Professional | None | $100.00 | $134.90 | $245.47 |
United Setting Facility Modifier None Typical Low $316.23 Median $1,380.38 Typical High $3,801.89 | Facility | None | $316.23 | $1,380.38 | $3,801.89 |
United Setting Professional Modifier None Typical Low $79.43 Median $104.71 Typical High $162.18 | Professional | None | $79.43 | $104.71 | $162.18 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $52.48 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $21.38 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $79.43 Typical High $89.13 | Professional | 54 · Surgery only | $77.62 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.72 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.47 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $74.13 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $72.44 | $74.13 | $83.18 |
Where New Jersey sits
The same service costs 4.5 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Jersey· 42nd of 51
$112
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.